摘要
目的采用光学相干断层扫描(optical coherence tomography,OCT)和其他泪膜检测指标评估不同大小的角膜切口对白内障超声乳化术后泪膜的影响。方法随机将年龄相关性白内障患者79例98眼分为2.2 mm组(46眼)和3.0 mm组(52眼),均行超声乳化白内障吸出联合人工晶状体植入术,于术前、术后1 d、7 d、1个月及3个月检测基础泪液分泌(schirmer I test,SⅠT)、泪膜破裂时间(break-up time,BUT)、干眼症状(dry eye symptoms,Sx)评分,并采用RTVue OCT检测泪河面积(tear meniscus area,TMA)、泪河高度(tear meniscus height,TMH)及泪河深度(tear meniscus area depth,TMD),对两组各项检测结果进行比较。结果与术前相比,术后1 d、7 d、1个月时2.2 mm组及3.0 mm组的Sx评分均升高(均为P<0.05),术后3个月时与术前差异均无统计学意义(均为P>0.05);术后7 d时2.2 mm组及3.0 mm组的BUT、SⅠT均不同程度降低(均为P<0.05),至术后1个月时2.2 mm组的SⅠT仍较低(P<0.05),而BUT与术前差异无统计学意义(P>0.05),3.0 mm组的BUT、SⅠT仍不同程度降低(均为P<0.05);术后1 d、7 d时2.2 mm组及3.0 mm组的TMA、TMH及TMD均比术前明显减小(均为P<0.05),术后1个月时2.2 mm组的TMA、TMH及TMD与术前差异均无统计学意义(均为P>0.05),而3.0 mm组的TMA及TMD仍比术前明显减小(均为P<0.05),TMH与术前差异无统计学意义(P>0.05)。两组之间相比,2.2 mm组的Sx评分在术后1 d、7 d时均比3.0 mm组低,差异均有统计学意义(均为P<0.05),术后1个月及3个月时两组的Sx评分差异均无统计学意义(均为P>0.05);2.2 mm组的BUT、SⅠT在术后7 d时均明显高于3.0 mm组(均为P<0.05),术后1个月及3个月时两组差异均无统计学意义(均为P>0.05);术后1 d、7 d时,2.2 mm组的TMA、TMH及TMD均显著高于3.0 mm组(均为P<0.05),术后1个月及3个月时两组差异均无统计学意义(均为P>0.05)。结论与3.0 mm透明角膜切口相比,2.2 mm透明角膜切口对眼表泪膜的影响更小,恢复更快。
Objective To evaluate the effects of different corneal incision sizes on tear film after phacoemulsification by optical coherence tomography（OCT） and other tear film examinations.Methods Ninty-eight eyes of 79 cases were randomly divided into 2.2 mm incision group and 3.0 mm incision group,then were performed by phacoemulsification and intraocular lens implantation.Schirmer I test（SIT）,tear film break-up time（BUT） and dry eye symptoms（Sx） at pre-operation and postoperative 1 day,7 days,1 month,3 months were detected,and tear meniscus area（TMA）,tear meniscus height（TMH） and tear meniscus depth（TMD） were also measured by RTVue OCT.The results were compared between the two groups.Results Sx of 2.2 mm group and 3.0 mm group at 1 day,7 days,1 month postoperatively were higher than that preoperatively（all P〈0.05）,while there was no difference of Sx between 3 month postoperatively and preoperatively（P〉0.05）;BUT and SIT of 2.2 mm group and 3.0 mm group at 7 days postoperatively were all decreased（all P〈0.05）;SIT of 2.2 mm group at 1 month postoperatively was still lower than preoperatively（P〈0.05）,while there was no difference of BUT of2.2 mm group between postoperatively and preoperatively（P〉0.05）;BUT and SIT of 3.0mm group at 1 month postoperatively decreased（all P〈0.05）;TMA,TMH and TMD of 2.2mm group and 3.0 mm group at 1 day,7 days postoperatively were dramatically decreased than that preoperatively（all P〈0.05）,TMA,TMH and TMD of 2.2 mm group was no statistically different at 1 month postoperatively and preoperatively（all P〉0.05）;TMA and TMD of 3.0mm group at 1 month postoperatively were still decreased than preoperatively（all P〈0.05）,while there was no difference of TMH of 3.0 mm group between postoperatively and preoperatively（P〉0.05）.No difference existed of 2.2 mm group and 3.0 mm group at 3 months between postoperatively and preoperatively（P〉0.05）.Sx of 2.2 mm group at 1 day,7 day postoperatively was lower than those of 3.0 mm group,and the differences were statistically significant（all P〈0.05）,while there was no difference of Sx at 1 month,3 months postoperatively between the two groups（all P〉0.05）;BUT and SIT of 2.2 mm group were higher than those of 3.0 mm group at 7 day postoperatively（all P〈0.05）,while there was no statistical difference of BUT and SIT at 1 month and 3 month postoperatively between the two groups（all P〉0.05）;TM A,TMH and TMD of 2.2 mm group at 1 day,7 days postoperatively were all dramatically higher than those of 3.0 mm group（all P〈0.05）,while there was no statistical difference of TMA,TMH and TMD at 1 month and 3 month postoperatively between the two groups（all P〉0.05）.Conclusion 2.2 mm clear corneal incision has less effect on tear film than 3.0 mm clear corneal incision.
出处
《眼科新进展》
CAS
北大核心
2015年第12期1173-1176,共4页
Recent Advances in Ophthalmology
关键词
泪膜
白内障
光学相干断层扫描
泪河
tear film
cataract
optical coherence tomography
tear meniscus
